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General NPI Number Information
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NPI Number | 1891796041
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Entity Type | Organization
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Legal Business Name | THERAGROUP INC
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1815 PURDY AVE SUITE 100A
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City | MIAMI BEACH
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State | FL
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Zip | 33139-1425
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Country | US
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Telephone | 305-604-5591
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Fax |
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Provider Business Mailing Address
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Address Line | 1815 PURDY AVE SUITE 100A
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City | MIAMI BEACH
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State | FL
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Zip | 33139-1425
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Country | US
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Telephone | 305-604-5591
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Fax | 305-604-5592
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. PEDRO TOMAS MACHIN JR.
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Credential | OTR/L
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Telephone | 305-604-5591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 13065
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT 10360
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License Number State | FL
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